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Zilberman-Rudenko J, Zhao FZ, Reitsma SE, Mitrugno A, Pang J, Shatzel JJ, Rick B, Tyrrell C, Hasan W, McCarty OJT, Schreiber MA. Effect of Pneumatic Tubing System Transport on Platelet Apheresis Units. Cardiovasc Eng Technol 2018; 9:515-527. [PMID: 29785664 PMCID: PMC6168073 DOI: 10.1007/s13239-018-0361-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 05/08/2018] [Indexed: 01/23/2023]
Abstract
Platelet apheresis units are transfused into patients to mitigate or prevent bleeding. In a hospital, platelet apheresis units are transported from the transfusion service to the healthcare teams via two methods: a pneumatic tubing system (PTS) or ambulatory transport. Whether PTS transport affects the activity and utility of platelet apheresis units is unclear. We quantified the gravitational forces and transport time associated with PTS and ambulatory transport within our hospital. Washed platelets and supernatants were prepared from platelet apheresis units prior to transport as well as following ambulatory or PTS transport. For each group, we compared resting and agonist-induced platelet activity and platelet aggregate formation on collagen or von Willebrand factor (VWF) under shear, platelet VWF-receptor expression and VWF multimer levels. Subjection of platelet apheresis units to rapid acceleration/deceleration forces during PTS transport did not pre-activate platelets or their ability to activate in response to platelet agonists as compared to ambulatory transport. Platelets within platelet apheresis units transported via PTS retained their ability to adhere to surfaces of VWF and collagen under shear, although platelet aggregation on collagen and VWF was diminished as compared to ambulatory transport. VWF multimer levels and platelet GPIb receptor expression was unaffected by PTS transport as compared to ambulatory transport. Subjection of platelet apheresis units to PTS transport did not significantly affect the baseline or agonist-induced levels of platelet activation as compared to ambulatory transport. Our case study suggests that PTS transport may not significantly affect the hemostatic potential of platelets within platelet apheresis units.
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Affiliation(s)
- Jevgenia Zilberman-Rudenko
- Division of Trauma, Critical Care and Acute Care Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR, USA.
- Department of Biomedical Engineering, School of Medicine, Oregon Health & Science University, 3303 SW Bond Ave., Portland, OR, USA.
| | - Frank Z Zhao
- Division of Trauma, Critical Care and Acute Care Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Stephanie E Reitsma
- Department of Biomedical Engineering, School of Medicine, Oregon Health & Science University, 3303 SW Bond Ave., Portland, OR, USA
| | - Annachiara Mitrugno
- Department of Biomedical Engineering, School of Medicine, Oregon Health & Science University, 3303 SW Bond Ave., Portland, OR, USA
| | - Jiaqing Pang
- Department of Biomedical Engineering, School of Medicine, Oregon Health & Science University, 3303 SW Bond Ave., Portland, OR, USA
| | - Joseph J Shatzel
- Division of Hematology & Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Beth Rick
- Division of Trauma, Critical Care and Acute Care Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Christina Tyrrell
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA
| | - Wohaib Hasan
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA
| | - Owen J T McCarty
- Department of Biomedical Engineering, School of Medicine, Oregon Health & Science University, 3303 SW Bond Ave., Portland, OR, USA
| | - Martin A Schreiber
- Division of Trauma, Critical Care and Acute Care Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR, USA
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Zilberman-Rudenko J, Reitsma SE, Puy C, Rigg RA, Smith SA, Tucker EI, Silasi R, Merkulova A, McCrae KR, Maas C, Urbanus RT, Gailani D, Morrissey JH, Gruber A, Lupu F, Schmaier AH, McCarty OJT. Factor XII Activation Promotes Platelet Consumption in the Presence of Bacterial-Type Long-Chain Polyphosphate In Vitro and In Vivo. Arterioscler Thromb Vasc Biol 2018; 38:1748-1760. [PMID: 30354195 PMCID: PMC6205188 DOI: 10.1161/atvbaha.118.311193] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 06/12/2018] [Indexed: 01/22/2023]
Abstract
Objective- Terminal complications of bacterial sepsis include development of disseminated intravascular consumptive coagulopathy. Bacterial constituents, including long-chain polyphosphates (polyP), have been shown to activate the contact pathway of coagulation in plasma. Recent work shows that activation of the contact pathway in flowing whole blood promotes thrombin generation and platelet activation and consumption distal to thrombus formation ex vivo and in vivo. Here, we sought to determine whether presence of long-chain polyP or bacteria in the bloodstream promotes platelet activation and consumption in a coagulation factor (F)XII-dependent manner. Approach and Results- Long-chain polyP promoted platelet P-selectin expression, microaggregate formation, and platelet consumption in flowing whole blood in a contact activation pathway-dependent manner. Moreover, long-chain polyP promoted local fibrin formation on collagen under shear flow in a FXI-dependent manner. Distal to the site of thrombus formation, platelet consumption was dramatically enhanced in the presence of long-chain polyP in the blood flow in a FXI- and FXII-dependent manner. In a murine model, long-chain polyP promoted platelet deposition and fibrin generation in lungs in a FXII-dependent manner. In a nonhuman primate model of bacterial sepsis, pre-treatment of animals with an antibody blocking FXI activation by FXIIa reduced lethal dose100 Staphylococcus aureus-induced platelet and fibrinogen consumption. Conclusions- This study demonstrates that bacterial-type long-chain polyP promotes platelet activation in a FXII-dependent manner in flowing blood, which may contribute to sepsis-associated thrombotic processes, consumptive coagulopathy, and thrombocytopenia.
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Affiliation(s)
| | - Stephanie E. Reitsma
- Biomedical Engineering, School of Medicine, Oregon Health & Science University, Portland, OR, USA
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Cristina Puy
- Biomedical Engineering, School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Rachel A. Rigg
- Biomedical Engineering, School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Stephanie A. Smith
- Departments of Biological Chemistry & Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Erik I. Tucker
- Biomedical Engineering, School of Medicine, Oregon Health & Science University, Portland, OR, USA
- Aronora Inc., Portland, OR, USA
| | - Robert Silasi
- Cardiovascular Biology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Alona Merkulova
- Division of Hematology and Oncology, Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Keith R. McCrae
- Department of Hematology-Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Coen Maas
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Rolf T. Urbanus
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht, Netherlands
| | - David Gailani
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | - James H. Morrissey
- Departments of Biological Chemistry & Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - András Gruber
- Biomedical Engineering, School of Medicine, Oregon Health & Science University, Portland, OR, USA
- Aronora Inc., Portland, OR, USA
- Division of Hematology, Oregon Health & Science University, Portland, OR, USA
| | - Florea Lupu
- Cardiovascular Biology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Alvin H. Schmaier
- Division of Hematology and Oncology, Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Division of Hematology and Oncology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Owen J. T. McCarty
- Biomedical Engineering, School of Medicine, Oregon Health & Science University, Portland, OR, USA
- Division of Hematology, Oregon Health & Science University, Portland, OR, USA
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Activated Monocytes Enhance Platelet-Driven Contraction of Blood Clots via Tissue Factor Expression. Sci Rep 2017; 7:5149. [PMID: 28698680 PMCID: PMC5506001 DOI: 10.1038/s41598-017-05601-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 05/31/2017] [Indexed: 01/13/2023] Open
Abstract
Platelet-driven reduction in blood clot volume (clot contraction or retraction) has been implicated to play a role in hemostasis and thrombosis. Although these processes are often linked with inflammation, the role of inflammatory cells in contraction of blood clots and thrombi has not been investigated. The aim of this work was to study the influence of activated monocytes on clot contraction. The effects of monocytes were evaluated using a quantitative optical tracking methodology to follow volume changes in a blood clot formed in vitro. When a physiologically relevant number of isolated human monocytes pre-activated with phorbol-12-myristate-13-acetate (PMA) were added back into whole blood, the extent and rate of clot contraction were increased compared to addition of non-activated cells. Inhibition of tissue factor expression or its inactivation on the surface of PMA-treated monocytes reduced the extent and rate of clot contraction back to control levels with non-activated monocytes. On the contrary, addition of tissue factor enhanced clot contraction, mimicking the effects of tissue factor expressed on the activated monocytes. These data suggest that the inflammatory cells through their expression of tissue factor can directly affect hemostasis and thrombosis by modulating the size and density of intra- and extravascular clots and thrombi.
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Zilberman-Rudenko J, Sylman JL, Garland KS, Puy C, Wong AD, Searson PC, McCarty OJT. Utility of microfluidic devices to study the platelet-endothelium interface. Platelets 2017; 28:449-456. [PMID: 28358586 DOI: 10.1080/09537104.2017.1280600] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The integration of biomaterials and understanding of vascular biology has led to the development of perfusable endothelialized flow models, which have been used as valuable tools to study the platelet-endothelium interface under shear. In these models, the parameters of geometry, compliance, biorheology, and cellular complexity are varied to recapitulate the physical biology of platelet recruitment and activation under physiologically relevant conditions of blood flow. In this review, we summarize the mechanistic insights learned from perfusable microvessel models and discuss the potential utility as well as challenges of endothelialized microfluidic devices to study platelet function in the bloodstream in vitro.
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Affiliation(s)
- Jevgenia Zilberman-Rudenko
- a Biomedical Engineering, School of Medicine , Oregon Health and Science University , Portland , OR , USA
| | - Joanna L Sylman
- a Biomedical Engineering, School of Medicine , Oregon Health and Science University , Portland , OR , USA
| | - Kathleen S Garland
- a Biomedical Engineering, School of Medicine , Oregon Health and Science University , Portland , OR , USA.,c Division of Pediatric Hematology/Oncology , Oregon Health and Science University , Portland , OR , USA
| | - Cristina Puy
- a Biomedical Engineering, School of Medicine , Oregon Health and Science University , Portland , OR , USA
| | - Andrew D Wong
- b Institute for Nanobiotechnology (INBT) , Johns Hopkins University , Baltimore , MD , USA.,d Department of Materials Science and Engineering , Johns Hopkins University , Baltimore , MD , USA
| | - Peter C Searson
- b Institute for Nanobiotechnology (INBT) , Johns Hopkins University , Baltimore , MD , USA.,d Department of Materials Science and Engineering , Johns Hopkins University , Baltimore , MD , USA
| | - Owen J T McCarty
- a Biomedical Engineering, School of Medicine , Oregon Health and Science University , Portland , OR , USA.,c Division of Pediatric Hematology/Oncology , Oregon Health and Science University , Portland , OR , USA
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Zilberman-Rudenko J, Sylman JL, Lakshmanan HHS, McCarty OJT, Maddala J. Dynamics of blood flow and thrombus formation in a multi-bypass microfluidic ladder network. Cell Mol Bioeng 2016; 10:16-29. [PMID: 28580033 DOI: 10.1007/s12195-016-0470-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The reaction dynamics of a complex mixture of cells and proteins, such as blood, in branched circulatory networks within the human microvasculature or extravascular therapeutic devices such as extracorporeal oxygenation machine (ECMO) remains ill-defined. In this report we utilize a multi-bypass microfluidics ladder network design with dimensions mimicking venules to study patterns of blood platelet aggregation and fibrin formation under complex shear. Complex blood fluid dynamics within multi-bypass networks under flow were modeled using COMSOL. Red blood cells and platelets were assumed to be non-interacting spherical particles transported by the bulk fluid flow, and convection of the activated coagulation factor II, thrombin, was assumed to be governed by mass transfer. This model served as the basis for predicting formation of local shear rate gradients, stagnation points and recirculation zones as dictated by the bypass geometry. Based on the insights from these models, we were able to predict the patterns of blood clot formation at specific locations in the device. Our experimental data was then used to adjust the model to account for the dynamical presence of thrombus formation in the biorheology of blood flow. The model predictions were then compared to results from experiments using recalcified whole human blood. Microfluidic devices were coated with the extracellular matrix protein, fibrillar collagen, and the initiator of the extrinsic pathway of coagulation, tissue factor. Blood was perfused through the devices at a flow rate of 2 µL/min, translating to physiologically relevant initial shear rates of 300 and 700 s-1 for main channels and bypasses, respectively. Using fluorescent and light microscopy, we observed distinct flow and thrombus formation patterns near channel intersections at bypass points, within recirculation zones and at stagnation points. Findings from this proof-of-principle ladder network model suggest a specific correlation between microvascular geometry and thrombus formation dynamics under shear. This model holds potential for use as an integrative approach to identify regions susceptible to intravascular thrombus formation within the microvasculature as well as extravascular devices such as ECMO.
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Affiliation(s)
| | - Joanna L Sylman
- Biomedical Engineering, School of Medicine, Oregon Health and Science University, Portland, OR
| | - Hari H S Lakshmanan
- Chemical and Biomedical Engineering, West Virginia University, Morgantown, WV
| | - Owen J T McCarty
- Biomedical Engineering, School of Medicine, Oregon Health and Science University, Portland, OR
| | - Jeevan Maddala
- Biomedical Engineering, School of Medicine, Oregon Health and Science University, Portland, OR
- Chemical and Biomedical Engineering, West Virginia University, Morgantown, WV
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